Overview

Address
1900 W 1st Street, Winston-Salem, NC 27104
Phone
3367242821
Certified beds
230
Avg daily residents
217 (94% of beds filled)
Ownership
For-profit corporation
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1973-07-01
Setting
Urban
1 /5
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
1/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
1/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
1/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
1/5
Quality Measures breakdown
Long-Stay Quality Measures 2/5
Short-Stay Quality Measures 1/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
3.38 3.74 3.48 ≥ 3.48 Below floor
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
0.26 0.65 0.26 ≥ 0.55 Below floor
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
0.56 0.83 0.58
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
2.56 2.26 2.64
Licensed (RN + LPN)
Combined licensed nurse coverage.
0.82
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
0.03

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
3.11
hrs / resident / day
RN (weekend)
0.22
hrs / resident / day
Total nurse (adjusted, weekend)
3.21
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
61.3%
annual
RN turnover
58.8%
annual
Administrators departed
1
last 12 months

Resident acuity

Nursing Case-Mix Index
1.33
higher acuity than avg
Case-Mix Index Ratio
0.96
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-08-29 9 7 4 106 1 106
Cycle 2/3 (prior) 2024-07-02 34 25 24 412 1 412
Total weighted health score
182.5
lower is better

Deficiencies (48)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

4 A/B/C No actual harm — minor
37 D/E/F Actual harm — potential for minor
3 G/H/I Actual harm
4 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0565 Honor the resident's right to organize and participate in resident/family groups in the facility. D 2025-08-29 2025-09-24
0646 Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. D 2025-08-29 2025-09-24
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2025-08-29 2025-09-23
0814 Dispose of garbage and refuse properly. F 2025-08-29 2025-09-23
0880 Provide and implement an infection prevention and control program. J 2025-08-29 2025-09-24
0585 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. B 2025-08-29 2025-09-23
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. D 2025-08-29 2025-09-24
0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. E 2025-06-25 2025-07-17
0690 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. D 2025-06-25 2025-07-17
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. G 2024-11-22 2024-10-02
0583 Keep residents' personal and medical records private and confidential. D 2024-07-02 2024-07-17
0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. D 2024-07-02 2024-07-17
0641 Ensure each resident receives an accurate assessment. D 2024-07-02 2024-07-17
0644 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. E 2024-07-02 2024-07-17
0695 Provide safe and appropriate respiratory care for a resident when needed. D 2024-07-02 2024-07-17
0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. E 2024-07-02 2024-07-17
0758 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. D 2024-07-02 2024-07-17
0761 Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. E 2024-07-02 2024-07-17
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2024-07-02 2024-07-17
0883 Develop and implement policies and procedures for flu and pneumonia vaccinations. D 2024-07-02 2024-07-17
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. G 2024-07-02 2024-07-17
0561 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. D 2024-07-02 2024-07-17
0569 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. B 2024-07-02 2024-07-17
0576 Ensure residents have reasonable access to and privacy in their use of communication methods. C 2024-07-02 2024-07-17
0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. E 2024-07-02 2024-07-17
0585 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. D 2024-07-02 2024-07-17
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. G 2024-07-02 2024-07-17
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2024-07-02 2024-07-17
0657 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. D 2024-07-02 2024-07-17
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. D 2024-07-02 2024-07-17
0745 Provide medically-related social services to help each resident achieve the highest possible quality of life. D 2024-07-02 2024-07-17
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2024-07-02 2024-07-17
0759 Ensure medication error rates are not 5 percent or greater. D 2024-07-02 2024-07-17
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. E 2024-07-02 2024-07-17
0924 Put firmly secured handrails on each side of hallways. E 2024-07-02 2024-07-17
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. D 2023-11-21 2023-08-29
0867 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. D 2023-11-21 2023-12-19
0565 Honor the resident's right to organize and participate in resident/family groups in the facility. E 2023-08-07 2023-09-06
0578 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. D 2023-08-07 2023-09-06
0637 Assess the resident when there is a significant change in condition D 2023-08-07 2023-09-06
0638 Assure that each resident’s assessment is updated at least once every 3 months. B 2023-08-07 2023-09-06
0641 Ensure each resident receives an accurate assessment. D 2023-08-07 2023-09-06
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. J 2023-08-07 2023-08-07
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. J 2023-08-07 2023-08-07
0692 Provide enough food/fluids to maintain a resident's health. J 2023-08-07 2023-08-07
0803 Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. E 2023-08-07 2023-09-06
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. E 2023-08-07 2023-09-06
0867 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. E 2023-08-07 2023-09-06

Penalties (5)

Fines issued
5
last 3 years
Total fines
$283,330
Date Type Fine amount
2024-07-02 Fine $8,018
2024-07-02 Fine $8,783
2024-11-22 Fine $12,529
2025-06-25 Fine $22,320
2023-08-07 Fine $231,680

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 1.7% Medicaid 86.3% Other 12.0%

Operating performance

Operating Margin
0.3%
Total Margin
0.2%
Occupancy Rate
87.6%

Revenue & costs

Net Patient Revenue
$22.0M
Total Costs
$1.3M
Net Income
$52K

Balance sheet

Total Assets
$9.5M
Total Liabilities
$4.1M
Fund Balance
$5.4M
Current Ratio
1.04

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: ALLIANCE HEALTH GROUP

Chain ID
714
Facilities in chain
10
Legal business name
WEST FIRST STREET OPERATING COMPANY LLC
Chain-average star ratings (for peer context)
Overall
1.3
Health
1.6
Staffing
1.8
QM
1.6

Owner / manager organizations (3)

Organization Role Association
ALIGNMENT HOLDCO LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 08/01/2024
COALITION GROUP LLC 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 08/01/2024
ALLIANCE HEALTH GROUP LLC OPERATIONAL/MANAGERIAL CONTROL since 08/01/2024

Owner / manager individuals (3)

Name Role Association
EMANUEL, YOSEF 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 08/01/2024
CLARK, ARELYS OPERATIONAL/MANAGERIAL CONTROL since 08/01/2024
EMANUEL, YOSEF CORPORATE OFFICER since 08/01/2024

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 112 rows
Source Metric Value Raw key
Cost Report Current Ratio 1.04 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 86.3% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 1.7% metrics.medicare_day_share
Cost Report Net Income ($) $51,585 metrics.net_income
Cost Report Net Patient Revenue ($) $22,038,084 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 87.6% metrics.occupancy_rate
Cost Report Operating Margin (%) 0.3% metrics.operating_margin
Cost Report Total Assets ($) $9,517,866 metrics.total_assets
Cost Report Total Costs ($) $1,318,730 metrics.total_costs
Cost Report Total Fund Balances ($) $5,449,398 metrics.fund_balance
Cost Report Total Liabilities ($) $4,068,468 metrics.total_liabilities
Cost Report Total Margin (%) 0.2% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.58276 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 2.63744 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.26456 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.48476 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 3.20787 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 217.1 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.83016 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.25618 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.65435 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 3.74068 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.29702 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 1.6 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 1.3 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 1.6 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 1.8 Chain Average Staffing Rating
Provider Information Chain ID 714 Chain ID
Provider Information Chain Name ALLIANCE HEALTH GROUP Chain Name
Provider Information City/Town Winston-Salem City/Town
Provider Information CMS Certification Number (CCN) 345092 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Forsyth County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1973-07-01 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote Geocoding Footnote
Provider Information Health Inspection Rating 1 Health Inspection Rating
Provider Information Health Inspection Rating Footnote Health Inspection Rating Footnote
Provider Information Latitude 36.0964 Latitude
Provider Information Legal Business Name WEST FIRST STREET OPERATING COMPANY LLC Legal Business Name
Provider Information Location 1900 W 1st Street,Winston-Salem,NC,27104 Location
Provider Information Long-Stay QM Rating 2 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote Long-Stay QM Rating Footnote
Provider Information Longitude -80.273 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 1 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 230 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 10 Number of Facilities in Chain
Provider Information Number of Fines 5 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.32516 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 0.96190 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 1 Overall Rating
Provider Information Overall Rating Footnote Overall Rating Footnote
Provider Information Ownership Type For profit - Corporation Ownership Type
Provider Information Physical Therapist Staffing Footnote Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 1900 W 1st Street Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name Willow Valley Center for Nursing and Rehabilitatio Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 330 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 1 QM Rating
Provider Information QM Rating Footnote QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 106 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 4 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 7 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-08-29 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 106 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 9 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 25 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2024-07-02 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 412 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 24 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 412 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 34 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.22330 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 58.8 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 0.82093 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 0.56461 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.55530 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.03446 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.25632 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 3.37623 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 1 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote Short-Stay QM Rating Footnote
Provider Information Special Focus Status Special Focus Status
Provider Information Staffing Rating 1 Staffing Rating
Provider Information Staffing Rating Footnote Staffing Rating Footnote
Provider Information State NC State
Provider Information Telephone Number 3367242821 Telephone Number
Provider Information Total Amount of Fines in Dollars 283330.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 3.10797 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 5 Total Number of Penalties
Provider Information Total nursing staff turnover 61.3 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 182.500 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 27104 ZIP Code